Individual
LINDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37073 MILL RUN AVE, GEISMAR, LA 70734-3236
(225) 610-5404
Mailing address
37073 MILL RUN AVE, GEISMAR, LA 70734-3236
(225) 610-5404
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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